Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v 0Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> �* r <br /> 2� C ° <br /> rn <br /> OWNER TELEPHONE / °' <br /> w <br /> . 0 <br /> = x <br /> HOME ADDRESSL_ C — 0 <br /> EMERGENCY/FIRE NUMBER 2- 5 3 ROAD NAME <br /> ��� ` <br /> LEGAL DESCRIPTION(see tax receipt) I <br /> /'� yr 1) J y <br /> ' m <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION PRIVY ❑ y o <br /> TYPE OF PERMIT(S): c 0 <br /> FILLING/GRADING ❑ CAMPING UNIT SUBDIVISION ❑ a <br /> STRUCTURE/ADDITION USE: `1 i 'RuufYI m: <br /> ° <br /> / (Home/Cabin; Commerciaf Business; droom; Deck,etc.) y <br /> BUILDING CONTRACTOR: �( f� �i C9 t l J / Q 9( � p 'Aj 'N <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> O <br /> N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEM O o <br /> T a <br /> o Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. � <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m 2F <br /> NORTH(N). C n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO 9 <br /> BUILDINGS, ROADS, LAKE, LOT LINES. ::� <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. I <br /> N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR,ETC.,THE PLANS � <br /> MUST BE SIGNED AND DATED BY THE OWNER. c I <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHENq o <br /> NEEDED. Cr <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: P <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. Q <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> ;a - 0 r., MOM <br /> 6. 3nOm <br /> ym�° : °f° <br /> 7. Z <br /> o i � .� <br /> .y jm <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my c ; p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of 'm C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m io m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> Inn <br /> s- p <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am 10 <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other 2 <br /> authorized person to hav96ccessItthe above desc ' e prerpises at any reasonable time for the purpose of inspection. o <br /> SIGN HERE � d' <br /> (signage of o-r/wneerr�or building contrac (date) <br /> ZONING ADMINISTRATOR �i:m l�lni <br /> N N V1NNf)1N <br /> Ut N O NtT00 <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br />